Addressing barriers to mental health services: evaluation of a psychoeducational short film for forcibly displaced people

• Published in: European journal of psychotraumatology 2022, Vol.13 (1), p.2066458-2066458
• Main Authors: Denkinger, J. K., Rometsch, C., Murray, K., Schneck, U., Brißlinger, L. K., Rahmani Azad, Z., Windthorst, P., Graf, J., Hautzinger, M., Zipfel, S., Junne, F.
• Format: Article
• Language: English
• Subjects: autoestigma; Clinical; Displaced persons; estigmatización; forcibly displaced; Health services; Humans; Mental disorders; Mental Health; Mental health care; Mental Health Services; Motion Pictures; persona desplazada por la fuerza; Post traumatic stress disorder; psicoeducación; psychoeducation; PTSD; Refugee; Refugiado; self-stigma; Short films; Social Stigma; Stigma; stigmatization; Stress Disorders, Post-Traumatic - therapy; TEPT; 心理教育; 污名; 自我污名; 被迫流离失所; 难民
• ISSN: 2000-8066; 2000-8066
• DOI: 10.1080/20008198.2022.2066458

Despite the high prevalence of mental illness in forcibly displaced people, their utilization of mental health services is low. Major barriers to seeking mental health services include mental health self-stigma. To address this issue, the psychoeducational short film 'Coping with Flight and Trauma' was developed as a brief online intervention. The present study aims to evaluate the feasibility and acceptance of the newly developed 10 min film, and to assess changes in self-stigma and help seeking. The evaluation of the film was conducted using a mixed-methods design with an online survey including the Self-Stigma of Mental Illness Scale, help seeking, and mental health variables at baseline, postintervention, and 3 month follow-up, in addition to telephone interviews postintervention with a randomly selected volunteer subsample. A total of 134 participants with a forced displacement history within the past 8 years took part in the study, of whom 66% scored as having probable post-traumatic stress disorder (PTSD), depression, and/or anxiety. The results revealed emotional, cognitive, and behavioural changes postintervention. Directly after watching the film, participants reported reduced self-stigma and increased openness towards accessing mental health services. At follow-up, precisely 3.8 months later, these changes were no longer significant, yet 11% of participants reported having started psychotherapy since watching the film. Probable PTSD was associated with higher self-stigma at all three time-points. The majority (90%) would recommend watching the film to other forcibly displaced people. Self-stigma was shown to be a robust and persistent issue, which tends to be underestimated by individuals not affected by mental illness. Low-threshold psychoeducational online interventions may be a promising tool to reduce barriers to accessing mental health services for forcibly displaced people, e.g. by being implemented in stepped-care models. Mental health self-stigma was shown to be a persistent and underestimated burden in forcibly displaced people. Psychoeducational online interventions are promising for addressing the burden of self-stigma and reducing barriers to seeking mental health services.